Senior Center Evaluation Survey

Thank you for helping to evaluate the Senior Activity Center. Your honest responses help us better serve you and provide us with valuable data.

Please only respond to this survey once per year. We estimate this survey will take you five minutes to complete.

All text responses may be used without attribution in marketing and fundraising materials.

Think about your life since you started attending the Montpelier Senior Activity Center. Below are some ways that senior centers might make a difference. Please put a check in the box that best matches your response for each statement.

Because I go to the Senior Activity Center, I...

Question Title

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1.Think about your life since you started attending the Montpelier Senior Activity Center. Below are some ways that senior centers might make a difference. Please put a check in the box that best matches your response for each statement.

Because I go to the Senior Activity Center, I...

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

Do more volunteer work

Do more volunteer work Strongly Agree

Do more volunteer work Agree

Do more volunteer work Neutral

Do more volunteer work Disagree

Do more volunteer work Strongly Disagree

Do more volunteer work N/A

See friends more often/make new friends

See friends more often/make new friends Strongly Agree

See friends more often/make new friends Agree

See friends more often/make new friends Neutral

See friends more often/make new friends Disagree

See friends more often/make new friends Strongly Disagree

See friends more often/make new friends N/A

Take better care of my health

Take better care of my health Strongly Agree

Take better care of my health Agree

Take better care of my health Neutral

Take better care of my health Disagree

Take better care of my health Strongly Disagree

Take better care of my health N/A

Eat meals that are better for me

Eat meals that are better for me Strongly Agree

Eat meals that are better for me Agree

Eat meals that are better for me Neutral

Eat meals that are better for me Disagree

Eat meals that are better for me Strongly Disagree

Eat meals that are better for me N/A

Have more energy

Have more energy Strongly Agree

Have more energy Agree

Have more energy Neutral

Have more energy Disagree

Have more energy Strongly Disagree

Have more energy N/A

Feel happier or more satisfied with my life

Feel happier or more satisfied with my life Strongly Agree

Feel happier or more satisfied with my life Agree

Feel happier or more satisfied with my life Neutral

Feel happier or more satisfied with my life Disagree

Feel happier or more satisfied with my life Strongly Disagree

Feel happier or more satisfied with my life N/A

Have something to look forward to each day

Have something to look forward to each day Strongly Agree

Have something to look forward to each day Agree

Have something to look forward to each day Neutral

Have something to look forward to each day Disagree

Have something to look forward to each day Strongly Disagree

Have something to look forward to each day N/A

Know where to ask if I need a service such as a ride to the doctor or an aide

Know where to ask if I need a service such as a ride to the doctor or an aide Strongly Agree

Know where to ask if I need a service such as a ride to the doctor or an aide Agree

Know where to ask if I need a service such as a ride to the doctor or an aide Neutral

Know where to ask if I need a service such as a ride to the doctor or an aide Disagree

Know where to ask if I need a service such as a ride to the doctor or an aide Strongly Disagree

Know where to ask if I need a service such as a ride to the doctor or an aide N/A

Feel more able to stay independent

Feel more able to stay independent Strongly Agree

Feel more able to stay independent Agree

Feel more able to stay independent Neutral

Feel more able to stay independent Disagree

Feel more able to stay independent Strongly Disagree

Feel more able to stay independent N/A

Feel that the senior center has had a positive effect on my life

Feel that the senior center has had a positive effect on my life Strongly Agree

Feel that the senior center has had a positive effect on my life Agree

Feel that the senior center has had a positive effect on my life Neutral

Feel that the senior center has had a positive effect on my life Disagree

Feel that the senior center has had a positive effect on my life Strongly Disagree

Feel that the senior center has had a positive effect on my life N/A

Learn new things

Learn new things Strongly Agree

Learn new things Agree

Learn new things Neutral

Learn new things Disagree

Learn new things Strongly Disagree

Learn new things N/A

Have learned about services and benefits

Have learned about services and benefits Strongly Agree

Have learned about services and benefits Agree

Have learned about services and benefits Neutral

Have learned about services and benefits Disagree

Have learned about services and benefits Strongly Disagree

Have learned about services and benefits N/A

Am more physically active

Am more physically active Strongly Agree

Am more physically active Agree

Am more physically active Neutral

Am more physically active Disagree

Am more physically active Strongly Disagree

Am more physically active N/A

Please tell us how satisfied you are with the Montpelier Senior Activity Center by answering each question with a response ranging from Strongly Agree to Strongly Disagree. Please put a check in the box that best matching your response for each statement.

Question Title

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2.Please tell us how satisfied you are with the Montpelier Senior Activity Center by answering each question with a response ranging from Strongly Agree to Strongly Disagree. Please put a check in the box that best matching your response for each statement.

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

N/A

Overall the senior center is clean and attractive.

Overall the senior center is clean and attractive. Strongly Agree

Overall the senior center is clean and attractive. Agree

Overall the senior center is clean and attractive. Neutral

Overall the senior center is clean and attractive. Disagree

Overall the senior center is clean and attractive. Strongly Disagree

Overall the senior center is clean and attractive. N/A

Staff is professional.

Staff is professional. Strongly Agree

Staff is professional. Agree

Staff is professional. Neutral

Staff is professional. Disagree

Staff is professional. Strongly Disagree

Staff is professional. N/A

Staff is responsive to my needs.

Staff is responsive to my needs. Strongly Agree

Staff is responsive to my needs. Agree

Staff is responsive to my needs. Neutral

Staff is responsive to my needs. Disagree

Staff is responsive to my needs. Strongly Disagree

Staff is responsive to my needs. N/A

Staff is friendly and courteous.

Staff is friendly and courteous. Strongly Agree

Staff is friendly and courteous. Agree

Staff is friendly and courteous. Neutral

Staff is friendly and courteous. Disagree

Staff is friendly and courteous. Strongly Disagree

Staff is friendly and courteous. N/A

Staff is knowledgeable of activities and services.

Staff is knowledgeable of activities and services. Strongly Agree

Staff is knowledgeable of activities and services. Agree

Staff is knowledgeable of activities and services. Neutral

Staff is knowledgeable of activities and services. Disagree

Staff is knowledgeable of activities and services. Strongly Disagree

Staff is knowledgeable of activities and services. N/A

I feel appreciated as a volunteer.

I feel appreciated as a volunteer. Strongly Agree

I feel appreciated as a volunteer. Agree

I feel appreciated as a volunteer. Neutral

I feel appreciated as a volunteer. Disagree

I feel appreciated as a volunteer. Strongly Disagree

I feel appreciated as a volunteer. N/A

I am happy with the exercise and fitness classes offered.

I am happy with the exercise and fitness classes offered. Strongly Agree

I am happy with the exercise and fitness classes offered. Agree

I am happy with the exercise and fitness classes offered. Neutral

I am happy with the exercise and fitness classes offered. Disagree

I am happy with the exercise and fitness classes offered. Strongly Disagree

I am happy with the exercise and fitness classes offered. N/A

I am happy with the health and wellness education presentations and clinics.

I am happy with the health and wellness education presentations and clinics. Strongly Agree

I am happy with the health and wellness education presentations and clinics. Agree

I am happy with the health and wellness education presentations and clinics. Neutral

I am happy with the health and wellness education presentations and clinics. Disagree

I am happy with the health and wellness education presentations and clinics. Strongly Disagree

I am happy with the health and wellness education presentations and clinics. N/A

I am happy with the educational classes offered

I am happy with the educational classes offered Strongly Agree

I am happy with the educational classes offered Agree

I am happy with the educational classes offered Neutral

I am happy with the educational classes offered Disagree

I am happy with the educational classes offered Strongly Disagree

I am happy with the educational classes offered N/A

I am happy with the recreational and social activities offered.

I am happy with the recreational and social activities offered. Strongly Agree

I am happy with the recreational and social activities offered. Agree

I am happy with the recreational and social activities offered. Neutral

I am happy with the recreational and social activities offered. Disagree

I am happy with the recreational and social activities offered. Strongly Disagree

I am happy with the recreational and social activities offered. N/A

I am happy with the membership benefits offered.

I am happy with the membership benefits offered. Strongly Agree

I am happy with the membership benefits offered. Agree

I am happy with the membership benefits offered. Neutral

I am happy with the membership benefits offered. Disagree

I am happy with the membership benefits offered. Strongly Disagree

I am happy with the membership benefits offered. N/A

I would recommend the senior activity center to a friend

Question Title

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3.I would recommend the senior activity center to a friend

Strongly Agree

Somewhat Agree

Neutral

Somewhat Disagree

Strongly Disagree

I participate in the following activities at the Senior Activity Center

Question Title

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4.I participate in the following activities at the Senior Activity Center

In general, how often do you come to the senior center?

Question Title

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5.In general, how often do you come to the senior center?

Daily

2-4 Times/Week

1 Time/Week

1-3 Times/Month

Less than once/month

Daily

2-4 Times/Week

1 Time/Week

1-3 Times/Month

Less than once/month

Approximately how long have you been coming to the Senior Activity Center?

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6.Approximately how long have you been coming to the Senior Activity Center?

<1 year

1-5 Years

6-10 Years

10+ Years

<1 year

1-5 Years

6-10 Years

10+ Years

Please tell us how participating in the Senior Activity Center has changed your life.

Question Title

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7.Please tell us how participating in the Senior Activity Center has changed your life.

Please provide any additional comments or feedback on the Senior Activity Center.

Question Title

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8.Please provide any additional comments or feedback on the Senior Activity Center.

What is your age?

Question Title

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9.What is your age?

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

What is your approximate household income? (OPTIONAL)

Question Title

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10.What is your approximate household income? (OPTIONAL)

$0-$19,999

$20,000-$39,999

$40,000-$59,999

$60,000-$79,999

$80,000-$99,999

$100,000-$149,999

$150,000 and up

We'd love to hear from you. If you have more feedback you'd like to share, please don't hesitate to contact us at 223-2518 or stop by the office. Thank you!